NPIMap

Organization Active NPI

Make a Change Transitional Center for Women

  • Substance Abuse Rehabilitation Facility
  • Houston, TX
National Provider Identifier
1619546611
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MAKE A CHANGE TRANSITIONAL CENTER FOR WOMEN
Practice address
11710 Briar Forest Dr Apt 1806
Houston, TX 77077-5043
Phone
(616) 334-3602
NPI assigned
Jun 23, 2021
Last updated
Jun 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Mamie KelleyNPI 1265001655
Title
Founder
Phone
(616) 334-3602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Assisted Living Facility (Mental Illness) 3104A0625X
Substance Abuse Rehabilitation Facility 324500000X Primary
Peer Specialist 175T00000X

Addresses

Primary practice location

11710 Briar Forest Dr Apt 1806
Houston, TX 77077-5043

Mailing address

11710 Briar Forest Dr Apt 1806
Houston, TX 77077-5043
Phone (616) 334-3602

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1619546611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 BRIAR FOREST DR APT 1806",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775043",
            "telephone_number": "616-334-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 BRIAR FOREST DR APT 1806",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775043",
            "telephone_number": "616-334-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKE A CHANGE TRANSITIONAL CENTER FOR WOMEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "616-334-3602",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.